Q&A with Physical Therapist Elizabeth Campos
The word osteoporosis can strike fear in the hearts of many older women—and men. Who hasn't seen the bent spines of the people it afflicts and who hasn't heard of the consequences that can happen: first a fall, then a fracture, then cascading problems, including loss of mobility and independence and serious medical problems such as blood clots, pneumonia and further frailty from lack of activity.
But according to Elizabeth Campos, a physical therapist at H&D Dynamic Therapy in New York City, there's a lot you can do even if you have already been diagnosed or have experienced fractures.
A: Osteoporosis refers to loss of bone density, which can lead to fractures. It can affect any bone in the body; it can affect anyone at any age. People who are healthy, exercise regularly and eat a calcium-rich diet are still at risk. Osteoporosis is called a silent disease because you do not necessarily feel pain. The first sign of osteoporosis is height loss, postural changes (such as dowager’s hump) and stress fractures; a wrist fracture can also signal of osteoporosis. Fractures occur on the front of the backbone (trabecular bone) under the stomach muscles, not the spiny part of the bone in the back that sticks out. Statistically speaking, most compression fractures occur between T6 and T12/L1 levels. That’s why people with osteopenia, a precursor to full-blown osteoporosis, should be careful about which exercises they do. For instance, they should avoid abdominals curls or “crunches” because that can lead to fractures. People with osteoporosis must be careful in daily activities, too: They can actually fracture bones coughing or getting out of a chair while rounding the spine instead of lengthening it.
A Weight-bearing exercise is the most important thing you can do. Weight-bearing means you’re on your feet, therefore the exercise bike is not weight bearing. (Neither is swimming.) A skilled physical therapist can show you simple exercises you can do at home to help strengthen your bones. I recommend the exercises in Walk Tall by Sara Meeks. (See sidebar.)
Here’s one good technique for strengthening the deep abdominal muscles: lie on your back and push the knees against palms and vice versa. Another great exercise is the “Spinal Decompression” recommended in Meeks’ book. Simply lie flat on your back with your knees bent, hip-width apart with arms at your side for 5 to 15 minutes twice daily. This exercise increases tolerance for lying on your back, helps align the spine and re-hydrates the discs between the vertebrae.
A. There’s a brace called the Spinomed III that can be enormously beneficial. You wear it for up to two hours a day, and it helps reactivate postural muscles that have been dormant. Patients love it because it’s very comfortable. Best of all, the Spinomed III brace is covered by Medicare.
Still not convinced you should do your exercises? Here’s the clincher: You’ll feel better, improve your strength and energy and, as Elizabeth notes, you’ll look younger: “People with osteoporosis are often motivated to improve their posture because they don’t want to look old,” she says.
Walk Tall by Sara Meeks is an excellent reference for more exercises. Meeks, a physical therapist with nearly 50 years’ experience, is on a mission to educate the general public about the proper way to exercise for spine health. (Hint: abdominal crunches are the worst thing for your spine if you have weak bones!) Her book contains a full-body program that is designed for bone health and also offers ways to improve balance, sitting, walking and other functional activities. Meeks shows you the right way to get out of bed in the morning, unload the dishwasher without bending your spine and how to sweep, vacuum and make the bed without endangering your bones. This is a must-have for anyone concerning with maintaining good posture, as well as those with osteopenia or osteoporosis.